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Bilateral axillary artery cannulation for severely calcified aorta and branches: a case report
Ken Okamoto1, Toshihiro Fukui2
1Department of Cardiovascular Surgery, Kumamoto University Hospital, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
Insights
A novel surgical approach using bilateral axillary artery cannulation and moderate hypothermic circulatory arrest successfully addressed aortic valve replacement in a patient with a severely calcified aorta, preventing neurological complications.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Vascular Surgery
Background:
- Aortic valve surgery presents significant challenges in patients with severely calcified aortas.
- Optimal arterial cannulation sites and the use of aortic clamping for neurological complication prevention remain undefined.
Observation:
- A case of aortic valve replacement is presented in a patient with a severely calcified aorta and stenotic side branches.
- The procedure utilized bilateral axillary artery cannulation.
- Short-term moderate hypothermic circulatory arrest was employed for aortic cross-clamping.
Findings:
- Successful aortic valve replacement was achieved using the described technique.
- This approach effectively prevented neurological complications in the patient.
- The porcelain aorta was successfully cross-clamped under moderate hypothermia.
Implications:
- Bilateral axillary artery cannulation is a viable strategy for complex aortic valve replacement.
- Moderate hypothermic circulatory arrest offers a safe method for cross-clamping porcelain aortas.
- This technique may improve outcomes for patients with severe aortic calcification undergoing valve replacement.
Background:
Aortic valve surgery in patients with severely calcified aortas is technically challenging. Additionally, the choice of arterial cannulation site and whether to perform an aortic clamp to prevent neurological complications are poorly defined.
Case Presentation:
We describe a patient with a severely calcified aorta and stenosis of its side branches. He successfully underwent aortic valve replacement with bilateral axillary artery cannulation and short-term moderate hypothermic circulatory arrest for cross-clamping of a severely calcified aorta to prevent neurological complications.
Conclusions:
Bilateral axillary artery cannulation and short-term moderate hypothermic circulatory arrest for cross-clamping of the porcelain aorta is a suitable option to prevent neurological complications in patients with a severely calcified aorta and stenosis of its side branches who need aortic valve replacement.
